Syndrome of Inappropriate Antidiuretic Hormone Secretion and Ibuprofen, a Rare Association to Be Considered: Role of Tolvaptan
The association between the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) is rare and has never been treated with an arginine vasopressin receptor antagonist. We report a unique case of SIADH associated with ibuprofen us...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2013/818259 |
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| author | Nathan Artom Silvia Oddo Aldo Pende Luciano Ottonello Massimo Giusti Franco Dallegri |
| author_facet | Nathan Artom Silvia Oddo Aldo Pende Luciano Ottonello Massimo Giusti Franco Dallegri |
| author_sort | Nathan Artom |
| collection | DOAJ |
| description | The association between the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) is rare and has never been treated with an arginine vasopressin receptor antagonist. We report a unique case of SIADH associated with ibuprofen use and successfully treated with tolvaptan. A 76-year-old man came to our observation because of lumbar pain and epigastric discomfort. He was taking ibuprofen orally 400 mg bid as an analgesic treatment. Laboratory tests showed low levels of sodium (116 mmol/L) and chloride; a diagnosis of SIADH was formulated and ibuprofen was stopped immediately. Imaging tests allowed to rule out the presence of malignancies or cerebral and lung diseases. Slightly hypertonic saline infusion was administered for 3 days without significant sodium improvement; therefore, tolvaptan was started at the initial dose of 7.5 mg daily, doubled after 5 days. After 8 days of treatment the patient showed progressive increase of sodium levels up to normal values. In the following weeks tolvaptan was prescribed at progressively titrated dosage to full suspension; afterwards the sodium levels remained normal without any type of treatment. |
| format | Article |
| id | doaj-art-cb3aa1afbfe8418a8fc1e8144c8b3bd9 |
| institution | DOAJ |
| issn | 2090-6501 2090-651X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Endocrinology |
| spelling | doaj-art-cb3aa1afbfe8418a8fc1e8144c8b3bd92025-08-20T03:19:29ZengWileyCase Reports in Endocrinology2090-65012090-651X2013-01-01201310.1155/2013/818259818259Syndrome of Inappropriate Antidiuretic Hormone Secretion and Ibuprofen, a Rare Association to Be Considered: Role of TolvaptanNathan Artom0Silvia Oddo1Aldo Pende2Luciano Ottonello3Massimo Giusti4Franco Dallegri5Clinic of Internal Medicine 1, Department of Internal Medicine, University of Genoa School of Medicine, Viale Benedetto XV, 6, 16132 Genoa, ItalyDivision of Endocrinology, Department of Endocrinological and Metabolic Sciences, University of Genoa School of Medicine, Genoa, ItalyClinic of Internal Medicine 1, Department of Internal Medicine, University of Genoa School of Medicine, Viale Benedetto XV, 6, 16132 Genoa, ItalyClinic of Internal Medicine 1, Department of Internal Medicine, University of Genoa School of Medicine, Viale Benedetto XV, 6, 16132 Genoa, ItalyDivision of Endocrinology, Department of Endocrinological and Metabolic Sciences, University of Genoa School of Medicine, Genoa, ItalyClinic of Internal Medicine 1, Department of Internal Medicine, University of Genoa School of Medicine, Viale Benedetto XV, 6, 16132 Genoa, ItalyThe association between the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) is rare and has never been treated with an arginine vasopressin receptor antagonist. We report a unique case of SIADH associated with ibuprofen use and successfully treated with tolvaptan. A 76-year-old man came to our observation because of lumbar pain and epigastric discomfort. He was taking ibuprofen orally 400 mg bid as an analgesic treatment. Laboratory tests showed low levels of sodium (116 mmol/L) and chloride; a diagnosis of SIADH was formulated and ibuprofen was stopped immediately. Imaging tests allowed to rule out the presence of malignancies or cerebral and lung diseases. Slightly hypertonic saline infusion was administered for 3 days without significant sodium improvement; therefore, tolvaptan was started at the initial dose of 7.5 mg daily, doubled after 5 days. After 8 days of treatment the patient showed progressive increase of sodium levels up to normal values. In the following weeks tolvaptan was prescribed at progressively titrated dosage to full suspension; afterwards the sodium levels remained normal without any type of treatment.http://dx.doi.org/10.1155/2013/818259 |
| spellingShingle | Nathan Artom Silvia Oddo Aldo Pende Luciano Ottonello Massimo Giusti Franco Dallegri Syndrome of Inappropriate Antidiuretic Hormone Secretion and Ibuprofen, a Rare Association to Be Considered: Role of Tolvaptan Case Reports in Endocrinology |
| title | Syndrome of Inappropriate Antidiuretic Hormone Secretion and Ibuprofen, a Rare Association to Be Considered: Role of Tolvaptan |
| title_full | Syndrome of Inappropriate Antidiuretic Hormone Secretion and Ibuprofen, a Rare Association to Be Considered: Role of Tolvaptan |
| title_fullStr | Syndrome of Inappropriate Antidiuretic Hormone Secretion and Ibuprofen, a Rare Association to Be Considered: Role of Tolvaptan |
| title_full_unstemmed | Syndrome of Inappropriate Antidiuretic Hormone Secretion and Ibuprofen, a Rare Association to Be Considered: Role of Tolvaptan |
| title_short | Syndrome of Inappropriate Antidiuretic Hormone Secretion and Ibuprofen, a Rare Association to Be Considered: Role of Tolvaptan |
| title_sort | syndrome of inappropriate antidiuretic hormone secretion and ibuprofen a rare association to be considered role of tolvaptan |
| url | http://dx.doi.org/10.1155/2013/818259 |
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